Insurance Carrier	Facility/Professional	Modifier	Low Price	Median Price	High Price
Aetna Facility/Professional Facility Modifier Low / Median / High Price $137.93 / $137.93 / $139.31	Facility		$137.93	$137.93	$139.31
Aetna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $143.44	Professional		$137.93	$137.93	$143.44
BCBS Facility/Professional Facility Modifier Low / Median / High Price $5,456.92 / $5,821.21 / $8,577.84	Facility		$5,456.92	$5,821.21	$8,577.84
Christus Facility/Professional Facility Modifier Low / Median / High Price $80.00 / $121.37 / $121.37	Facility		$80.00	$121.37	$121.37
Cigna Facility/Professional Facility Modifier Low / Median / High Price $130.12 / $137.93 / $137.93	Facility		$130.12	$137.93	$137.93
Cigna Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $137.93	Professional		$137.93	$137.93	$137.93
Lucent Health Facility/Professional Facility Modifier Low / Median / High Price $170.37 / $183.47 / $1,027.45	Facility		$170.37	$183.47	$1,027.45
Lucent Health Facility/Professional Professional Modifier Low / Median / High Price $1,027.45 / $1,027.45 / $1,027.45	Professional		$1,027.45	$1,027.45	$1,027.45
Moda Health Facility/Professional Facility Modifier Low / Median / High Price $108.60 / $137.93 / $292.41	Facility		$108.60	$137.93	$292.41
Moda Health Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $172.41	Professional		$137.93	$137.93	$172.41
Oscar Health Facility/Professional Professional Modifier Low / Median / High Price $148.10 / $191.82 / $523.60	Professional		$148.10	$191.82	$523.60
Providence Facility/Professional Facility Modifier Low / Median / High Price $137.93 / $137.93 / $291.85	Facility		$137.93	$137.93	$291.85
Providence Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $182.17	Professional		$137.93	$137.93	$182.17
United Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $141.52	Professional		$137.93	$137.93	$141.52
Wellpoint Facility/Professional Professional Modifier Low / Median / High Price $137.93 / $137.93 / $232.71	Professional		$137.93	$137.93	$232.71